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PloS One 2023This study aims to investigate socioeconomic disparities in nutritional status among ever-married women in Bangladesh and to break down urban-rural differences in the...
This study aims to investigate socioeconomic disparities in nutritional status among ever-married women in Bangladesh and to break down urban-rural differences in the underlying causes of undernutrition. We utilized data from the Bangladesh Demographic and Health Survey 2017-18, a sample size of 18328 ever-married women, including 5170 from urban residences, and 13159 from rural residences. To explore socioeconomic inequality, we employed a concentration indexing measure, while a multiple binary logistic regression model was carried out to identify the determinants associated with the outcome variable. A Blinder-Oaxaca decomposition analysis was performed to decompose the urban-rural gap in women's nutritional status using associated factors. The prevalence of undernutrition among ever-married women in Bangladesh was 12 percent. Notably, this percentage varied by region, with urban residents accounting for 8.6% and rural residents accounting for 13.3%. Our findings confirmed that undernutrition was more prevalent among women with lower wealth indexes in Bangladesh, as indicated by the concentration index (CIX = -0.26). The multivariable analysis investigating the determinants of undernutrition status among ever-married women, with a focus on residence revealed significant associations with respondent age, education, marital status, mass media access, wealth status, and division. According to the Blinder-Oaxaca decomposition and its extension, the prevalence was significantly higher in rural residences of Bangladesh than in urban residences, and the endowment effect explained 86 percent of the total urban-rural difference in undernutrition prevalence. The results of this study indicate that the factors that influence women's nutritional status in rural areas play a significant role in the gap, and the majority of the gap is caused by education and economic position. In order to effectively promote maternal health policies in Bangladesh, intervention techniques should be created that are aimed at the population, that is, the poorest and least educated.
Topics: Humans; Female; Socioeconomic Factors; Rural Population; Nutritional Status; Bangladesh; Urban Population; Malnutrition
PubMed: 38096318
DOI: 10.1371/journal.pone.0289880 -
BMC Women's Health Nov 2023The most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to...
Trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women, based on the 2000, 2005, 2011, and 2016 Ethiopian demographic and health survey.
BACKGROUND
The most common family planning method is modern contraception. It is a cost-effective way to reduce maternal and neonatal morbidity and mortality and enable women to make informed choices about their reproductive and sexual health. The trend of modern contraceptive utilization has shown drastic change in Ethiopia, and identifying the major factors contributing to such a drastic change is vital to improving plans and strategies for family planning programs. Therefore, this study analyzed the trend, geographical distribution, and determinants of modern contraceptive use among married reproductive-age women in Ethiopia.
METHOD
This study used secondary data from the EDHS 2000-2016, collected from a population-based cross-sectional study by the Central Statistical Agency, focusing on married reproductive-age women aged 15-49. The study analyzed the modern contraceptive use trends through descriptive analyses conducted in three phases: 2000-2005, 2005-2011, and 2011-2016. The study utilized bivariable and multivariable logistic regression analyses to identify determinant factors, with significant variables declared using a P-value of 0.05 and an adjusted OR with 95% confidence interval. Analysis was conducted using STATA.14 and R. Spatial analysis was done using ArcGIS version 10.8 and SatScan version 9.6.
RESULT
A weighted total of 33,478 women are included in the study, with a mean age of 31.4 years (8.6 SD). There was a significant increase in the trend of modern contraceptive use among married women over the study period, from 2000 to 2016, from 7.2% to 2000 to 15.7% in 2005, to 30% in 2011, and to 39.5% in 2016. The maximum increase was seen in the second phase (2005-2011), with a 14.3% increase. Factors like age of respondents, educational status, religion, residence, region, wealth index, number of living children, husbands' desire to have more children, and media exposure were found to be predictors for modern contraceptive utilization.
CONCLUSION
The prevalence of modern contraceptive use is below 50%, and there is also evidence of wide geographical variation in modern contraceptive use in Ethiopia. Thus, policymakers, high institutions, and other stakeholders must work collaboratively with the government in order to improve awareness about modern contraceptive use.
Topics: Child; Infant, Newborn; Female; Humans; Adult; Contraceptive Agents; Cross-Sectional Studies; Contraception Behavior; Contraception; Family Planning Services; Marriage; Ethiopia
PubMed: 38012691
DOI: 10.1186/s12905-023-02789-z -
Frontiers in Neurology 2024For epilepsy, a common neurological disorder, brings psychosocial challenges like stigma, employment difficulties, and barriers to marriage and childbearing. Stigma...
INTRODUCTION
For epilepsy, a common neurological disorder, brings psychosocial challenges like stigma, employment difficulties, and barriers to marriage and childbearing. Stigma often stems from misconceptions and societal beliefs, particularly in less developed regions like Turkey. However, research on the marital and childbearing experiences of epilepsy patients in such settings is limited. We aimed to research the marriage and childbearing behaviors of men and women with epilepsy.
METHODS
We conducted a cross-sectional study involving 215 adult epilepsy patients at Antalya Training and Research Hospital between 2019 and 2022. Patients were asked questions about marriage and having children on prepared questionnaires.
RESULT
The gender distribution of the 215 patients included in the study was revealed to be 62.3% (134) females and 37.7% (81) males. 71.6% of patients were married, and 12.7% had no children. 33.3% of these patients stated that they did not desire children because of the disease. A statistically significant correlation was observed between the duration of the disease and being unmarried. A significant correlation was observed between age at disease onset and number of children.
CONCLUSION
Our study revealed the effects of individuals with epilepsy on marriage and childbearing, and as we know, it is the first study conducted in Turkey on childbearing attitudes in individuals with epilepsy. Despite medical and social developments, epilepsy is still one of the most stigmatized diseases, and the disease has considerable negative effects on marriage and fertility. Our study supported the findings of a small number of previous similar studies on this subject and additionally showed that the likelihood of having children decreased in patients using multiple ASM, and on the other hand, it showed that marriage positively affected patients in terms of social support.
PubMed: 38585357
DOI: 10.3389/fneur.2024.1304076 -
Inquiry : a Journal of Medical Care... 2024The stillbirth rate is among the most important indicators of access to and quality of care during pregnancy. This study investigated the factors related to the...
The stillbirth rate is among the most important indicators of access to and quality of care during pregnancy. This study investigated the factors related to the stillbirth rate in the Yazd province, Iran. The current research is descriptive and cross-sectional and the results of Shahdieh city cohort study which was conducted on 4756 women were used. Data related to the history of stillbirth, demographic characteristics, fertility history and, various female diseases were extracted from the results of the cohort study. The result shows that 7.2% of studied women had a history of stillbirth. Among the multiple variables, predictor variables including education level, marriage age, age of the first conception, number of children, consanguineous marriage, Employment status, and diseases like diabetes, hypertension, and history of depression had a significant relationship with a history of stillbirth ( ≤ .05). The stillbirth rate in Shahedieh is high compared to the global stillbirth Rate, but it is comparable with the stillbirth Rate in Yazd province. Although Yazd province, as one of the industrial hubs of Iran, has relatively acceptable indicators of income, employment, and medical and health facilities and welfare compared to other provinces, this study showed that factors such as diabetes, hypertension, low level of women's education, consanguineous marriage, and women's employment status and social welfare can affect Stillbirth Rate.
Topics: Child; Pregnancy; Humans; Female; Cohort Studies; Cross-Sectional Studies; Stillbirth; Hypertension; Diabetes Mellitus
PubMed: 38445612
DOI: 10.1177/00469580241236272 -
BMC Infectious Diseases Nov 2023Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that...
BACKGROUND
Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that examine whether polygamy is associated with safe sex negotiation among married women in sub-Saharan Africa, including Cameroon.
METHODS
Using the 2018 Cameroon Demographic and Health Survey, we apply logistic regression analysis to compare two indicators of safe sex negotiation (i.e., the ability to ask for condom use and refuse sex against their partner) between polygamous (n = 1,628) and monogamous (n = 5,686) women aged 15-49 years old.
RESULTS
We find that 67% and 50% of married women can ask for condom use and refuse sex against their partner, respectively. Multivariate analysis further reveals that women in polygamous relationships are less likely to report they can ask for condom use (OR = 0.71, p < 0.001) and refuse sex (OR = 0.64, p < 0.001) in comparison to their monogamous counterparts.
CONCLUSIONS
Our analysis found that in Cameroon, women in polygamous relationships, Muslim women, married women with inadequate HIV knowledge, those who had never been tested for HIV and women with lower socioeconomic status are less likely to negotiate for safe sex. Based on these findings, we discuss several implications for policymakers, including the establishment of a comprehensive family planning educational program and the deployment of community health workers to disseminate educational initiatives pertaining to safe sex negotiation to community members.
Topics: Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Safe Sex; Marriage; Negotiating; Cameroon; Sexual Behavior; HIV Infections; Condoms
PubMed: 37993765
DOI: 10.1186/s12879-023-08826-4 -
Narra J Aug 2023Herlyn-Werner-Wunderlich syndrome (HWWS), also known as OHVIRA syndrome (obstructed hemivagina and ipsilateral renal anomaly) is a complex congenital malformation...
Herlyn-Werner-Wunderlich syndrome (HWWS), also known as OHVIRA syndrome (obstructed hemivagina and ipsilateral renal anomaly) is a complex congenital malformation characterized by a triad including uterine didelphys, hemivaginal obstruction, and ipsilateral renal agenesis. In this case report, we present a case of HWWS along with the challenges in diagnosis and multi-step treatment processes. A 25-year-old woman presented to Dr. Zainoel Abidin Hospital in Banda Aceh, Indonesia with a chief complaint of lower back pain for the past six months (two months after the marriage). The patient also complained of late menstruation, followed by thick yellow vaginal discharge resembling malodorous pus occurring after menstruation. Additionally, a history of fever and pain during intercourse was reported. Vaginal examination revealed purulent fluid emerging from a pinpoint hole on the right vaginal wall. Vaginal palpation revealed a two-branched uterus, along with a palpable cystic mass on the right vaginal wall. Ultrasound examination indicated the presence of the right and left hemi-uteri, measuring 4.7x1.35 cm and 5.7x1.26 cm in size, respectively with both ovaries appearing normal. Fluid accumulation was observed in the right hemivagina, while the left kidney exhibited normal features, and the right kidney showed signs of hypoplasia. The patient was diagnosed with uterus didelphys, fluid accumulation in the hemivagina, and right kidney hypoplasia. Magnetic resonance imaging (MRI) confirmed uterus didelphys and revealed narrowing of the right hemivagina, suggestive of HWWS. Hysteroscopy was performed to resect the vaginal septum with laparoscopic guidance, along with drainage of hematocolpos, pyocolpos and placement of an intracervical mold. Despite HWWs having conservative gradual management, it was opted to perform vaginal septum resection, hematocolpos and pyocolpos drainage and placement of an intracervical mould in this case, in order to relieve symptoms and restore the reproductive and sexual functions.
PubMed: 38450268
DOI: 10.52225/narra.v3i2.223 -
Contraception and Reproductive Medicine Oct 2023Family planning (FP) is known to bring multiple benefits to people both individually and collectively. Individually, FP has been associated with reduction in risk of...
BACKGROUND
Family planning (FP) is known to bring multiple benefits to people both individually and collectively. Individually, FP has been associated with reduction in risk of unintended pregnancy which also correlates with low child mortality rates. Child mortality rates in women with child spacing of less than two years are 45% higher compared to their counterparts with child spacing of more than two years. Several factors that predict FP utilisation among women of childbearing age have been identified but there is limited literature on how migration impacts FP utilisation in Malawi. Our current study aimed at assessing the association between migration and modern contraceptive use among women of childbearing age in Malawi.
METHODS
Data for this study came from a nationally representative 2019/20 Malawi multiple cluster indicator survey (MICS). At total of 24,543 women aged 15 to 49 participated in the survey. Contraceptive prevalence rate (CPR) analyses were conducted separately on all women of childbearing age and married women. The data was analysed using the complex survey data approach by applying sampling weights to correct unequal representation of participants at cluster, district, and regional level. We used binary logistic regression to assess association between migration status and modern contraceptive use among all women of childbearing age and married women separately. We included age, age at first sex, age at marriage, region of residence, education, residence wealth index and presence of disability as confounders in our final multivariable models.
RESULTS
The overall CPRs for married women and for all women of childbearing age were 64.7% and 40.5% respectively. The CPRs for all women of childbearing age were 40.5% for non-migrants and 33.0% for migrant women. For married women, CPRs were 51.5% for migrant women and 65.5% for non-migrant women. The fully adjusted odds ratios for the association between migration status and modern contraceptive use were 0.62 (0.49-0.78) for married women and 0.65 (0.52-0.80) for all women of childbearing age.
CONCLUSIONS
We conclude from our findings that migrant women were significantly less likely to utilize modern contraceptive methods for both married women and all women of childbearing age. Deliberate efforts are required to ensure that migrant women of childbearing age have equal access to sexual and reproductive health services which includes family planning.
PubMed: 37891691
DOI: 10.1186/s40834-023-00254-8 -
SSM - Population Health Dec 2023This study examines the association between parental engagement and subsequent delayed marriage of adolescent girls and, secondarily, to assess whether parental...
Is parental engagement associated with subsequent delayed marriage and marital choices of adolescent girls? Evidence from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey in Uttar Pradesh and Bihar, India.
OBJECTIVE
This study examines the association between parental engagement and subsequent delayed marriage of adolescent girls and, secondarily, to assess whether parental engagement is positively associated with girls' involvement in marital decision-making regarding husband selection.
METHODS
The study used longitudinal survey data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) in Uttar Pradesh and Bihar, India. We analysed 6168 unmarried adolescent girls aged 15-19 years at wave 1 (2015-16) who were interviewed in wave 2 (2018-19). Our outcomes were delayed marriage of girls (unmarried vs. married at 20-22 vs. married at 18-19 vs. married at <18) and, among those married at <18 years, girls' involvement in husband selection (alone vs. with parents vs. not involved). Parental discussion around school performance, friendships, menstruation, pregnancy, free time, and personal issues were the exposure variables. We applied unadjusted and adjusted multinomial regression models to assess associations between our exposure variables and each outcome variable.
RESULTS
From wave 1 to wave 2, 1551 girls (31.2%) married; 567 girls (12.5%) married as minors (<18 years). We found that parental discussion around school performance (relative risk ratio [RRR]: 1.33), friendship (RRR: 1.37) and personal matters (RRR: 1.29) were positively associated with remaining unmarried relative to early marriage of girls. However, discussion with parents about menstruation was negatively associated with marriage at 20-22 (RRR: 0.67) and remaining unmarried (RRR: 0.80), compared to early marriage. Discussing school performance was negatively associated with marriage at 18-19 (RRR: 0.62) and at 20-22 (RRR: 0.50), relative to early marriage. Discussing personal issues with parents was positively associated with joint parent-girl decision-making regarding husband selection, relative to parents alone selecting the husband (RRR: 1.43).
CONCLUSIONS
Parental engagement on school performance, friendship, and personal issues in early adolescence may help delay marriage and support marital choice for girls in India.
PubMed: 37860704
DOI: 10.1016/j.ssmph.2023.101523 -
BMC Public Health Nov 2023This study aims to analyze the basic characteristics and mental health status of adult female callers to the psychological assistance helpline in Hangzhou City, in order...
OBJECTIVE
This study aims to analyze the basic characteristics and mental health status of adult female callers to the psychological assistance helpline in Hangzhou City, in order to provide targeted services for effectively intervening in the psychological crises of this group.
METHODS
Data from adult female callers to a helpline in Hangzhou City were collected between 2019 and 2022, encompassing demographic information and discussed issues. The data were analyzed according to age groups, marital status, and call times. The mental health status of the adult female population was measured by two indicators-mood status and suicide risk.
RESULTS
The study included 15,580 adult female callers. Among them, 52.2% were aged 30 and below, 62.1% were unmarried, and 42.6% were from other provinces. The primary types of calls were related to mental health (56.5%), romantic relationships (11%), and marriage/family issues (13%). Adults aged 30 and below had more consultations about romantic relationships, work, and study-related issues compared to those over 30. Those over 30 sought more advice on marriage/family and child education. Younger callers displayed higher levels of depression and suicide risk compared to older callers. Unmarried callers had a higher proportion of moderate depression and suicide risk than married callers. Higher education levels were associated with lower depression levels (OR = 0.631,95%CI:0.439-0.906, P = 0.013) and high-risk proportions (OR = 0.328,95%CI:0.147-0.733, P = 0.007). Late evening callers had a higher high-risk proportion (OR = 5.326,95%CI:2.633-10.775, P < 0.001), and employed individuals had lower high-risk proportions compared to unemployed callers (OR = 0.536,95%CI:0.320-0.897, P = 0.018).
CONCLUSION
The mental health status of female callers aged 30 and below, unemployed individuals, and those calling in the latter part of the night have relatively poorer mental health and are more likely to be at risk for suicide, which needs to be taken seriously, and more professional and targeted intervention services need to be enhanced in the hotline.
Topics: Adult; Female; Humans; Disease Susceptibility; Health Status; Hotlines; Mental Health; Retrospective Studies; Suicide
PubMed: 37986069
DOI: 10.1186/s12889-023-17085-6 -
BMC Public Health Aug 2023The COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision...
Married women's decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: online survey data analysis from 2020 to 2021.
BACKGROUND
The COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision to delay childbearing at a younger age are associated with a lower level of well-being and regrets when women start to desire a baby. Thus, the decision to delay childbearing due to the pandemic could negatively affect the well-being of women. This study focuses on how pregnancy decisions affect the well-being of women during the COVID-19 pandemic.
METHODS
From the Japan COVID-19 and Society Internet Survey, a nationally representative web-based survey, 768 observations of married women aged 18 to 50 years who had the intention of getting pregnant during the pre-pandemic period (conducted in 2020 and 2021) were used. Loneliness, severe psychological distress, and suicidal ideation were used as well-being indicators. For pooled data, a generalised estimated equation (GEE) model was used to estimate how pregnancy decision related to well-being indicators. For a sub-analysis, the sample was divided by the survey year and a Poisson regression model was used.
RESULTS
The GEE analysis showed an association between delaying childbearing and severe psychological distress, with the prevalence ratio (PR) being 2.06 [95% CI (1.40-3.03)]. Furthermore, loneliness and suicidal ideation that occurred after the beginning of the pandemic were significantly related to the decision to delay childbearing-1.55 [95% CI (1.03,2.34)] and 2.55 [95% CI (1.45-4.51)], respectively. Moreover, these PRs were larger for 2021 compared to 2020.
CONCLUSION
During the COVID-19 pandemic, approximately one-fifth of married women who had childbearing intentions before the pandemic decided to postpone pregnancy. They exhibited a deteriorated mental health state. Furthermore, the negative associations were larger in 2021 compared to 2020. Loneliness has negative consequences for both mental and physical health, as well as elevated severe psychological distress and suicidal ideation among those who decided to postpone pregnancy. Therefore, the current results should not be overlooked by society.
Topics: Infant; Pregnancy; Female; Humans; Suicidal Ideation; Loneliness; Pandemics; COVID-19; Psychological Distress; Data Analysis
PubMed: 37641039
DOI: 10.1186/s12889-023-16476-z